actually occurs on the unit is a stage of becoming a professional and feeling
comfortable with one’s own practice (MacIntosh, 2003). Eventually, new nurses
can work to change outdated practices through the proper channels.
After a short time in the orientation process, new employees begin to realize
the vast amount that they do not know about their specific practice area. This is
the time to read literature in this specialty practice area. Sometimes reviewing
nursing texts and past notes is sufficient. Now that specific practices are seen
on a daily basis in a new job, theory means more because it is applied. Explore
current research about new practices. Glean all that you can as soon as you can
to foster self-development in your new specialty area. Having a rationale for
making a practice change is helpful both to convince yourself that the change
can be effective and to convince others.
As their formal orientation is completed, new employees frequently expe-
rience a time of uncertainty. New nurses might question whether this is the
right unit or specialty area. They long for their days of classes when they had
more guidance as a student, and they struggle with learning the vast amount of
information about quality patient care. Moving from a novice to a competent
nurse can be frustrating, such as learning how to organize one’s shift with the
many tasks, delegating to unlicensed personnel, and managing patient crises.
It is so easy to leave work and want to forget about it. Yet this is the time when
a true innovator will set goals and strive toward enhanced professionalism.
Learn all that you can about your new practice and facility. Take advantage of
all learning opportunities. Push your comfort zone so that as you feel more
confident about one type of patient care diagnosis, you can seek out new op-
portunities for learning about other nursing interventions. Perhaps this is the
time to volunteer for a unit committee so that you can learn more about the
inner workings of creating and changing policy or to offer to present a topic
for a staff development class. Remind yourself that this is part of developing
as a professional.
Performance Appraisals and Reviews
In any job, there is some type of appraisal and review. Usually it is tied to sal-
ary or other promotional mechanisms, so it is important to pay attention to
the details applicable for your agency. This process is designed to provide an
opportunity to reflect on your strengths, areas for improvement, what you have
done since the last review, and what you plan to accomplish within the next
time period. Normally, setting goals is a part of this review process. However,
acting in a goal-centered manner provides a framework for practice as well.
Goals might be individual, such as seeking a promotion, or getting more active
in workgroups. Other goals might include activities to enhance professionalism,
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